at a glance
- CarePlus offers Medicare Advantage plans in select regions of Florida.
- Medicare Advantage plans from CarePlus all include prescription drug coverage.
- Many Medicare Advantage plans through CarePlus have a $0 monthly premium.
- CarePlus provided healthcare benefits to more than 168,829 members throughout Florida in 2020.
CarePlus is a private health insurance company that offers Medicare Advantage plans to people living in certain parts of Florida.
Medicare Advantage (Part C) is an alternative to original Medicare (parts A and B) that’s provided by a private insurance company. It covers your basic medical benefits, plus additional services that may include dental, hearing, and vision coverage, depending on the plan you choose.
Keep reading to learn more about the Medicare Advantage plans that CarePlus offers.
Below are some examples of plan categories that CarePlus Medicare Advantage plans fall under.
CarePlus HMO plans
All the CarePlus Medicare Advantage plans are what’s known as a Health Maintenance Organization (HMO).
With this plan, you’ll first choose a primary care provider from a list of CarePlus-approved providers. Moving forward, you’ll see your primary care provider for your general health needs and when you need a referral to a specialist.
Generally, you’ll need to see providers who are in CarePlus’s network to get the most coverage. If you need emergency care and are outside of your normal service area, though, out-of-network providers will be covered.
CarePlus HMO-POS plans
HMO Point-of-Service (HMO-POS) plans are similar to HMO plans. With an HMO-POS plan, you may be allowed to go to some providers who are out of network. However, your coinsurance or copayments for these services will be higher than if you were in network.
CarePlus offers two types of Medicare Advantage HMO-POS plans. They are:
- CareOne Plus (HMO-POS)
- CareOne Platinum (HMO-POS)
CarePlus HMO SNPs
Special Needs Plans (SNPs) are available to those who have needs that extend beyond typical Medicare Advantage plans. They are available to those with low incomes, chronic health conditions, and those who live at an inpatient facility, like a nursing home.
CarePlus offers two types of HMO SNPs:
- CareNeeds Plus (HMO D-SNP): This is a Dual Eligible SNP (D-SNP) that is offered to people who qualify for both Medicare and Medicaid.
- CareComplete (HMO C-SNP): This is a Chronic Condition SNP (C-SNP) that is available to anyone with Medicare who has been diagnosed with diabetes, cardiovascular disorders, or chronic heart failure.
All CarePlus Medicare Advantage plans include Part D prescription drug coverage. This coverage is detailed in the 2021 CarePlus Prescription Drug Guide. This guide lists the medications that each of its Medicare Advantage plans cover in different areas of Florida.
Medicare requires that you have some form of creditable prescription drug coverage. If you stick with original Medicare (Part A and Part B), you’ll need to purchase a separate Part D plan.
CarePlus only offers Medicare Advantage plans in the state of Florida. The plans are divided by “market regions” and further break down their coverage by county.
These market regions include:
- North Florida: Duval and Clay counties
- Daytona area: Volusia county
- Orlando area: Lake, Marion, Orange, Osceola, Seminole, and Sumter counties
- Tampa area: Hillsborough, Pasco, Pinellas, and Polk counties
- Space Coast: Brevard and Indian River counties
- South Florida: Broward, Miami-Dade, and Palm Beach counties
If you live in one of these service areas, you can compare the available CarePlus Medicare Advantage plans to select the best coverage for your needs.
Part of the value of Medicare Advantage plans is that they offer additional services beyond what original Medicare covers. For example, some preventive services they might cover include:
- dental benefits
- fitness and exercise classes
- hearing benefits
- preventive care rewards program
- vision benefits
Most CarePlus Medicare Advantage plans also offer services that may help if you need extra care. These include:
- access to a mail-order pharmacy with no delivery fees
- over-the-counter medical spending allowance
- meal program benefits after an inpatient hospital stay
- transportation services
- telehealth services
If you have a question about Medicare Advantage coverage through CarePlus, you can always contact the company directly.
Many CarePlus Medicare Advantage plans are premium-free. Although you’ll still pay your monthly Medicare Part B premium to Medicare, you’ll pay $0 for Medicare Advantage coverage.
It’s important to remember that you must choose CarePlus providers, medications, and pharmacies for CarePlus to provide your Medicare benefits.
Here’s a comparison of CarePlus plans and benefits in select Florida cities.
|City, plan||Star rating||Monthly premium||Yearly health deductible, drug deductible||In-network out-of-pocket max||Primary physician visit copay||Specialist visit copay|
|Daytona Beach, FL: CareOne Plus (HMO)||5||$0||$0, $0||$3,400||$0||$15|
|Jacksonville, FL: CareOne (HMO)||5||$0||$0, $0||$3,400||$0||$20|
|Fort Lauderdale, FL: CareFree (HMO)||5||$0||$0, $100||$3,400||$0||$25|
|Tampa, FL: CareNeeds Plus (HMO D-SNP)||5||$14||$0, $445||$3,400||$0||$0|
|Orlando, FL: CareComplete (HMO C-SNP)||5||$0||$0, $0||$3,400||$0||$20|
These are just a few examples of plans that CarePlus provides. You can see all available plans (or just search for CarePlus plans) in your area by using Medicare’s plan finder tool.
Medicare divides its health coverage into parts.
Part C (Medicare Advantage) offers the same coverage as Part A and Part B, but you purchase these plans through a private insurance company that contracts with Medicare.
When you choose a Medicare Part C plan, Medicare pays the insurance company a set amount. In return, the insurance companies contract with specific providers to receive discounts. The cost savings are then passed on to you through added health coverage offerings.
You’ll still pay your monthly Part B premium to Medicare. This is in addition to any premium associated with your Medicare Advantage plan.
- Available Medicare Advantage plans vary by geographic region.
- If you see an available CarePlus plan in your region that you’d like to sign up for, you can contact CarePlus directly to enroll.
- Medicare’s plan comparison tool may be the best place to start, so you can compare coverage and costs across different companies and plans in your area.